OBJECTIVE: To report the efficacy of vaginally administered bromocriptine. MATERIAL AND METHOD: Case report. RESULTS: The prolactin level was significantly decreased after the administration of bromocriptine vaginally. CONCLUSIONS: The vaginal administration of bromocriptine can be an alternative to oral administration in patients with hyperprolactinemia who show severe side effects.
Administration, Intravaginal ; Administration, Oral ; Bromocriptine* ; Humans ; Hyperprolactinemia* ; Prolactin

OBJECTIVE: To investigate the response of hyperplastic endometrium to Medroxyprogesterone acetate according to the histologic types such as simple typical, complex typical and atypical hyperplasia. METHODS: A total of 79 patients with histologically proved endometrial hyperplasia were enrolled into this prospective study between March 1996 and May 1998. Patients without atypia were placed on a regimen of cyclic therapy with 10mg MPA orally, each day for 14days per month for 3 months. In the cases in which hyperplasia did not regress , MPA was increased to 20mg. Patients with atypical hyperplasia received continuous MPA therapy, 20mg orally each day for 3 month. All patients were followed up for a minimum of 3 months and a maximum of 1 year(mean 7 months). RESULTS: In patients with simple typical hyperplasia, 45 patients(80.4%) had regression, 11 patients(19.6%) had persistence and none had progression. In patients with complex typical hyperplasia, 10 patients(83.3%) had regression, 2 patients(16.7%) had persistence and none had progression. But, in patients with atypical hyperplasia 5 patients(45.4%) had regression, 4 patients(36.4%) had persistence and 2(18.2%) patients had well differentiated endometrial adenocarcinoma. There was no recurrence during the follow up. CONCLUSION: This data suggest that most women with typical hyperplasia respond to progestin therapy, but there is high failure rate of response to progestin therapy and risk of endometrial cancer in patients with atypical hyperplasia. If the young patient desires to preserve her fertility, then progestin therapy may be considered as primary treatment in patients with atypical hyperplasia. But older patients in whom fertility is not an issue, hysterectomy should be selected as treatment of choice for atypical lesion.
Adenocarcinoma ; Endometrial Hyperplasia* ; Endometrial Neoplasms ; Endometrium ; Female ; Fertility ; Follow-Up Studies ; Humans ; Hyperplasia ; Hysterectomy ; Medroxyprogesterone Acetate ; Medroxyprogesterone* ; Prospective Studies ; Recurrence

No abstract available.
Arteriovenous Fistula* ; Humans ; Renal Dialysis*

No abstract available.
Arteriovenous Fistula* ; Humans ; Renal Dialysis*

We analyzed our experience of orchidopexies performed during last 10 years to evaluate results and to determine the possible approach to the treatment of undescended testes. Between 1988 and 1997, we had treated 420 undescended testes (314 palpable and 106 nonpalpable) in 356 boys. Average patient age at presentation was 4.1 years with 40.2% presenting before the age of 2 years. Of 106 nonpalpable testes, 23 testes were intraabdominal, 32 were preperitoneal and 51 were absent at the surgery. During the period of first 5 years, we had performed the surgery through 31 inguinal and 13 midline transabdominal incisions for 44 patients nonpalpable testes, while during the later 5 years, all 47 patients nonpalpable were treated through inguinal incisions. For the nonpalpable testes, the inguinal approach with or without intraperitoneal extension was successful in defining the location of testes and blind-ending vessels in all patients. Laparoscopy was not helpful in avoiding surgical exploration in all our patients with nonpalpable testes. Of 339 inguinal and midline transabdominal orchidopexies without spermatic vessels ligations, 324 testes were placed in the scrotum, 4 in the upper scrotum and 3 in the inguinal area. Eight were resulted in atrophy. Of 13 Fowler-Stephens orchidopexies, 7 were placed in the scrotum and 6 were resulted in atrophy. Testicular growths were noticed in most patients who underwent orchidopexies and the volume of fixed testes became as large as the contralateral normal testes by the mean duration of 43.3 months postoperatively. In conclusion, orchidopexies were successful in most cases of cryptorchidism in terms of testicular position and growth. However, there were more testicular atrophies in patient in whom spermatic vessels were ligated. In cases of nonpalpable undescended testis, the inguinal approach with or without intraperitoneal extension would be recommended.
Atrophy ; Cryptorchidism ; Humans ; Laparoscopy ; Ligation ; Male ; Orchiopexy* ; Scrotum ; Testis

PURPOSE: Epididymal anomalies in boys with an undescended testis have been well documented and most undescended testes are associated with patent processus vaginalis. However, the incidence of epididymal anomalies in descended testes has not well known. We performed a prospective study to determine the relationship between epididymal anomalies and patency of processus vaginalis in boys with hydrocele or cryptorchidism. MATERIALS AND METHODS: From January 1997 to February 1988, epididymal morphologies and the degrees of patency of processus vaginalis(closed, partially closed and open) were examined in 35 boys with hydrocele(37 testes) and 28 boys with cryptorchidism(29 testes) at the surgeries. RESULTS: No epididymal anomaly was found in all 3 hydroceles with closed processus vaginalis. Epididymal anomalies were found in 13 of 22 hydroceles with partially closed processus vaginalis and in 9 of 12 hydroceles with open processus vaginalis. All boys with undescended testes had open processus vagnialis and the epididymal anomalies were found in 27 of 29 undescended testes. The incidence of epididymal anomalies was highest in cryptorchid testes with open processus vaginalis and lowest in descended testes with closed processus vaginalis. Furthermore, epididymal anomalies were found to be more severe in association with more cranially located testes. CONCLUSIONS: The higher incidence of epididymal anomalies were associated with ipsilateral patency of processus vaginalis and testicular position. This finding suggests that the role of the epididymis in testicular descent may not be essential.
Cryptorchidism* ; Epididymis ; Incidence ; Male ; Prospective Studies ; Testis

Dislocation of the hemate bone is very rare. There is no reported case in Korea. The mechanism of injury may be attributed to direct trauma. We have experiened a case of dislocation of the hamate bone, treated it by open reduction and internal fixation using two Kirschner wires. The result was satisfactory. A case of dislocation of the hamte bone is reported with brief review of literature.
Bone Wires ; Dislocations ; Hamate Bone ; Korea

Three cases of severe spinal kyphotic deformities were treated with Halo-pelvic Apparatus. Among these three cases, two were tuberculous kyphotic deformities involving the thoracolumbar vertebrae with paraplegia. And the other one was cervical kyphotic deformity due to neurofibromatosis with neurologic involvement. The following results and considering problems were obtained. 1. Two cases of tuberculous kyphosis, 130° and 115°, were corrected to 120° and 100° respectively. And one case of neurofibromatic kyphosis, 90° was corrected to 53°. 2. Among two cases of tuberculosis in which the one was revealed full neurologic recovery, and the other resulted in permanent paraplegia. And a case of neurofibromatosis was fully recovered neurologically. 3. Total period of immobilization with Halo-pelvic Apparatus was 16, 18, 18 weeks in three cases respectively, but there was no avascular necrosis of odontoid process. 4. One case of neurofibromatosis with anterior spinal fusion revealed no loss of correction of kyphosis. But two cases of tuberculosis without anterior spinal fusion showed loss of correction of kyphosis, 20° respectively. 5. Removal of internal kyphosis was not easy, because it is likely to injury the blood supply to spinal cord. 6. During distraction, severe pain was noticed in the rib cage, which prevented further distraction. 7. After 9 weeks, ambulation with Halo-pelvic Apparatus was hindered with pain due to pelvic pin loosening. 8. In order to prevent loss of correction of kyphosis, it was considered that anterior spinal fusion should be followed by posterior spinal fusion.
Congenital Abnormalities ; Immobilization ; Kyphosis ; Necrosis ; Neurofibromatoses ; Odontoid Process ; Paraplegia ; Ribs ; Spinal Cord ; Spinal Fusion ; Spine ; Tuberculosis ; Walking

One hundred and seventy-two cases of tuberculosis of the bones and joints were treated at the department of orthopedic surgery, Inchon Christian Hospital during the 3 years and 10 months from March, 1979, to December, 1982. The results obtained were as followings: 1. The incidence was decreased progressively 1.92% in 1980 to 1.18 in 1982. 2. Tuberculous lesions involved spine(50.58%), knee(16.28%), hip(13.37%), ankle(2.33%) and greater trochanter(2.33%) in order. 3. Age and sex distribution were not remarkable. 4. The main associated tuberculous lesions were pulmonary tuberculosis and tuberculous pleurisy (20.65%). Therefore, pulmonary problems should be always carefully investigated in every case of skeletal tuberculosis. 5. Average duration of disease was one year and 3.5 months, average hospital days was one month. 6. Initial miss diagnosis of lesions ultimately proved to be tuberculosis. Rheumatoid arthritis:13 cases, Osteoarthritis : 3 cases, Herniated lumbar disc: 3 cases, Cellulitis :2 cases, Neoplasm :2 cases. Early diagnosis is essential since proper therapy is available and far advanced destruction, long suffering and disability can be avoided. 7. Post operative complication was mainly due to failure of bone graft in tuberculous spondylitis and was draining sinus formation and wound disruption in other skeletal tuberculosis. 8. The result of treatment of skeletal tuberculosis from conservative methods were relatively poor. The corroboratory care of skeletal tuberculosis can be obtained by extensive surgery.
Cellulitis ; Diagnosis ; Early Diagnosis ; Incheon ; Incidence ; Joints ; Orthopedics ; Osteoarthritis ; Sex Distribution ; Spondylitis ; Transplants ; Tuberculosis ; Tuberculosis, Pleural ; Tuberculosis, Pulmonary ; Wounds and Injuries

No abstract available.
Tibial Fractures*